付出就有回报：通过改进 CHG 沐浴，用数学模型和成本分析降低医院感染率。
You get back what you give: Decreased hospital infections with improvement in CHG bathing, a mathematical modeling and cost analysis.
机构信息
Department of Statistical Sciences and Operations Research, Virginia Commonwealth University, Richmond, VA; Department of Mathematics and Applied Mathematics, Virginia Commonwealth University, Richmond, VA.
Department of Mathematics and Applied Mathematics, Virginia Commonwealth University, Richmond, VA.
出版信息
Am J Infect Control. 2019 Dec;47(12):1471-1473. doi: 10.1016/j.ajic.2019.07.003. Epub 2019 Aug 7.
BACKGROUND
Multiple studies have shown that bathing with chlorhexidine gluconate (CHG) wipes reduces hospital-acquired infections (HAIs). We employed a mathematical model to assess the impact of CHG patient bathing on central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and hospital-onset Clostridium difficile (C diff) infections and the associated costs.
METHODS
Using a Markov chain, we examined the effect of CHG bathing compliance on HAI outcomes and the associated costs. Using estimates from 2 different studies on CHG bathing effectiveness for CLABSI, CAUTI, and C diff, the number of HAIs per year were estimated along with associated costs. The simulations were conducted, assuming CHG bathing at varying compliance rates.
RESULTS
At 32% reduction in HAI incidence, increasing CHG bathing compliance from 60% to 90% results in 20 averted infections and $815,301.75 saved cost.
CONCLUSIONS
As CHG bathing compliance increases, yearly HAIs decrease, and the overall cost associated with the HAIs also decreases.
背景
多项研究表明，使用洗必泰葡萄糖酸盐（CHG）湿巾擦浴可降低医院获得性感染（HAI）。我们采用数学模型评估 CHG 患者擦浴对中心静脉相关血流感染（CLABSI）、导管相关尿路感染（CAUTI）和医院获得性艰难梭菌（C diff）感染的影响及其相关成本。
方法
我们使用马尔可夫链，研究 CHG 擦浴依从性对 HAI 结局和相关成本的影响。利用两项关于 CHG 擦浴对 CLABSI、CAUTI 和 C diff 有效性的研究中的估计值，估算每年 HAI 的发生次数及相关成本。假设 CHG 擦浴的依从率不同，进行模拟。
结果
在 HAI 发生率降低 32%的情况下，将 CHG 擦浴依从率从 60%提高到 90%，可避免 20 例感染，节省 815301.75 美元的成本。
结论
随着 CHG 擦浴依从率的提高，每年的 HAI 减少，HAI 相关总成本也随之降低。
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